Earlier this month we marked the traditional “back to school” milestone of the day after Labor Day by examining some of the science documenting the importance of early childhood experiences to long-term health outcomes, as well as the economic returns on investments in high-quality early childhood programs. Counties have long recognized the importance of giving our youngest residents the best possible start in life, and have found creative approaches to work with child care providers, preschool classrooms, and parents to improve young children’s chances of leading successful, healthy lives.

Giles County won a 2015 VACo Achievement Award for its comprehensive approach to community health, a project in which access to pre-kindergarten figured prominently. In its description of its efforts, Giles County explained that it was aiming to improve the conditions affecting too many county residents, and thus the county’s well-being as a whole, such as poverty, low birth weight, limited educational opportunity, and premature death, and that its goal was to bolster protective factors such as “enhanced parental resilience, social connectedness, enhanced education levels and opportunity…improved knowledge of parenting and child development and social and emotional competence of children.” Giles County used federal grant money to build two additional pre-K classrooms, which would provide wrap-around services to students, including complete health screenings (to include vision and dental) and a strong family engagement component.

Washington County has made early childhood a priority in its efforts to reduce poverty in the county. In 2016, the County was one of only ten counties in the nation selected to receive a Rural Impact County Challenge Grant, which provided coaching resources to County leadership and a host of community partners, such as the school system and the local Smart Beginnings program. An early project undertaken by the group was an inventory of community resources and the compilation of a Resource Guide. Supervisor Allison Mays said in a VACo Spotlight interview last year, “We chose this project recognizing that sometimes people who need help are not even aware that these resources exist.” Washington County’s efforts were rewarded by its selection earlier this year by NACo as one of a handful of counties to participate in the Pritzker Children’s Initiative. Through the project, Washington County is expected to benefit from access to expertise from national organizations that are all working to promote kindergarten readiness.

Chesterfield County’s “Play Smart with Toddlers” program is a brilliant use of an existing community resource – the public library system – to help parents improve their ability to support their children’s cognitive and social development, as well as to introduce them to resources within Chesterfield County. The “Play Smart” sessions allow children to play with a variety of developmentally-appropriate toys, while community professionals educate parents on the benefits of play, as well as topics such as nutrition and language development, all in a fun, low-stress environment. Parents come away with the tools to promote learning at home, and community contacts, such as staff at the Health Department and Mental Health Support Services, who can serve as resources for questions about child development.

In another exemplary community partnership, Loudoun County worked with George Mason University faculty and interns to promote a healthy habit early in life, by encouraging children in Head Start or Virginia Preschool Initiative (VPI) classes to choose water when they are thirsty, rather than sugary drinks such as juice. An article by GMU staff explains that before the program was implemented, the preschoolers’ juice consumption was close to their recommended limit of sugar consumption for the entire day, so swapping out water made a big difference in potential weight gain, as well as the benefit of developing healthy habits at an early age. Instructors developed ways to make “water time” fun for the students, including a penguin mascot named “Captain Hydro.” The curriculum has been implemented in all the Head Start and VPI classrooms in Loudoun County. Although the program was implemented relatively recently, it is already demonstrating results: Health Nutrition Coordinator Kris Cadwell noted that children experienced a drop in body-mass index over the course of the year, and the benefits appear to have carried over from preschool to home, based on surveys of parents at the beginning and end of the year reporting an increase in children drinking water rather than juice.

Albemarle County has historically made high-quality preschool a priority. The Bright Stars program, which serves at-risk four-year-olds in classrooms within County elementary schools, has had impressive success in preparing children for kindergarten. A recent report on the program noted that while only 9 percent of participants met the Pre-K benchmarks for the Phonological Awareness Literacy Screening (PALS) test (which measures skills associated with successful reading development) when entering the program, 63 percent met the goals by the spring, and the gains appear to be maintained in kindergarten and beyond. Importantly, all Bright Stars alumni in grades K-5 have been promoted to the next grade level. The program blends funding from VPI (which includes a local match), supplemental local funding, and federal funds, including Title I and Early Childhood Special Education dollars. Participating children benefit from a holistic approach to well-being, which includes health and dental care; dental care is offered through a partnership with Sentara Martha Jefferson Hospital.

Voluntary home visiting programs have been shown to be effective in improving parenting skills and preventing child abuse. Programs vary slightly in the populations they serve and their administrative structure, but generally they involve trained staff, who may be nurses or community health workers, who work with parents with young children, sometimes beginning during pregnancy, to address risk factors that may impede healthy development or lead to Adverse Childhood Experiences. The Virginia Commission on Youth produced a helpful overview of the programs operating in Virginia, including Healthy Families, Comprehensive Health Investment Project, and Resource Mothers. The state supports these programs with funds from the Temporary Assistance for Needy Families block grant, as well as federal funding through the Maternal, Infant, and Early Childhood Home Visiting grant program. Healthy Families Fairfax is a public-private partnership among the Fairfax County Department of Family Services, the Fairfax County Health Department, and two community nonprofits (Northern Virginia Family Service and United Community Ministries). Fairfax County funds the program, along with state funding and contributions by donors; the program works with parents who are at risk of abuse and neglect from pregnancy until the child reaches age three, and offers home-based parenting and health education, developmental screenings, and referrals to community resources. The program has been a resounding success: in 2017, less than one percent of the families in the program were later found to have abused or neglected their children, 84 percent of participants demonstrated positive parenting, and 89 percent of women who enrolled in the program while pregnant delivered babies at a healthy birth weight. These encouraging findings are in keeping with a statewide evaluation of the program performed by consultants on behalf of Prevent Child Abuse of Virginia, which found that Healthy Families participants received prenatal care, addressed developmental delays early, and had healthy home environments.

The evidence is clear that our experiences in early childhood lay the foundation for our future success, including our long-term health. Counties are making wise investments in their youngest residents, and it will be exciting to see these investments reap dividends in the future in the form of healthier communities. In my next column, we’ll be exploring poverty, an issue that is intertwined with many other aspects of community health, as well as efforts to improve the economic health of our communities.